Novosti
Khirurgii

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Year 2013 Vol. 21 No 2

ANESTHESIOLOGY-REANIMATOLOGY

S.A. TACHYLA1, À.V. ÌàRACHKAU1, N.Î. ÌàKSUTA2 , N.V. ÀKULICH2

INFLUENCE OF VARIOUS VARIANTS OF THE MULTICOMPONENT BALANCED ANAESTHESIA ON THE LEUKOCYTE FORMULA AND PHAGOCYTIC ACTIVITY IN BLOOD OF THE PATIENTS

ME "Mogilev Regional Hospital" 1,
ME "Mogilev Regional Hospital named A.A. Kulrshov 2".
The Republic of Belarus

Objectives. To carry out comparative analysis of different variants effects of the multicomponent balanced anesthesia using isoflurane/nitrous oxide/fentanyl, sevoflurane/nitrous oxide/fentanyl and propofol/fentanyl on leukocytes: their number, composition and phagocytic activity of polymorphonuclear leukocytes.
Methods. Analysis of the number and function of leukocytes during general anesthesia at laparoscopic cholecystectomy was performed in 50 patients (3 males and 47 females, aged 51,5±12,4 years, weight 84,5±18,4 kg). At several stages of anesthesia the changes in the quantity of leukocytes, granulocytes and lymphocytes and phagocytic activity of polymorphonuclear leukocytes were determined.
Results. It has been found out that during the multicomponent balanced anesthesia with the use of sevoflurane/nitrous oxide/fentanyl and propofol/fentanyl the number of leukocytes, granulocytes and lymphocytes intraoperatively doesn’t differ from baseline and the multicomponent balanced anesthesia using isoflurane/nitrous oxide/fentanyl decreases the number of leukocytes and granulocytes during surgery. In the postoperative period leukocytosis, granulocytosis and relative lymphopenia were registered. Phagocytic activity of leukocytes decreased during general anesthesia. The intensity of fluorescence was significantly lower in the group with propofol/fentanyl application compared with group of sevoflurane/nitrous oxide/fentanyl application.
Conclusions. During anesthesia the changes of the number of leukocytes, granulocytes and lymphocytes along with stable hemodynamic parameters, oxygenation, ventilation, sufficiently deep anesthesia according to monitoring data of electroencephalography and neuromuscular block characterize an adequate level of anesthesia protection of patients against a operation trauma. In our study all three variants of the multicomponent balanced anesthesia have the ability to reduce the phagocytic index that anesthesiologist should take into account during anesthesia.

Keywords: general anesthesia, isoflurane, sevoflurane, propofol, fentanyl, leukocytes, phagocytosis
p. 82 – 88 of the original issue
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Address for correspondence:
212016, Respublika Belarus', g. Mogilev, ul. Belynitskogo-Biruli, d. 12, UZ «Mogilevskaia oblastnaia bol'nitsa», reanimatsionno-anesteziologicheskoe otdelenie,
e-mail: tsa80@inbox.ru,
Tochilo Sergei Anatol'evich
Information about the authors:
Tachyla S.A. An anesthesiologist-resuscitator of ME "Mogilev Regional Hospital".
Marachkau A.V. MD, a head of the anesthesiology and intensive care unit of ME "Mogilev Regional Hospital".
Maksuta N.O. A post-graduate student of the biology chair of EE "Mogilev State University named after A.A. Kuleshov”.
Akulich N.V. PhD, a head of the ecological physiology chair of EE "Mogilev State University named after A.A. Kuleshov”.
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